亚低温对重型颅脑伤患者血糖和糖代谢相关激素水平的影响  

Effect of mild hypothermia on related hormones during glycometabolism in patients with severe traumatic brain injury

作　　者：吴江[1] 林晓元[1] 徐建民[1] 周育瑾[1] 林合麟[1] 黎国雄[1] 陈辉清[1] 黄振林[1] 

机构地区：[1]深圳市西乡人民医院神经外科,518102

出　　处：《中华创伤杂志》2001年第1期29-31,共3页Chinese Journal of Trauma

基　　金：深圳市科委自然科学基金资助项目!(19980 5 0 19)

摘　　要：目的　研究亚低温治疗对重型颅脑损伤患者糖代谢相关激素的影响及其意义。　方法　亚低温治疗组选择符合条件的重型颅脑损伤患者 (GCS 3～ 8分 )共 2 4例 ,于伤后 2 4h内行亚低温治疗 ,控制直肠温度 33～ 35℃ ,持续 3～ 5d ;对照组 2 1例 (GCS 3～ 8分 )。两组患者伤后急性期 (<48h)清晨空腹抽取静脉血标本 ,采用放射免疫分析法检测血清中胰岛素、皮质醇及生长激素含量。　结果　对照组患者血糖值为 (10 .2 5± 4.18)mmol L ,皮质醇为 (4 2 4.6 7± 12 5 .85 )ng L ;亚低温组患者血糖值为 (8.40± 3.75 )mmo L ,皮质醇为 (2 90 .71± 110 .5 0 )ng L ,两组比较差异均有显著性意义 (P <0 .0 1)。两组患者胰岛素和生长激素无明显变化。　结论　亚低温治疗能够减轻糖代谢相关激素紊乱 ,降低高血糖 。Objective To investigate the effect of mild hypothermia on related hormones during glycometabolism in the patients with severe brain injury. Methods Mild hypothermia was used within 24 hours after injury to keep the rectal temperature at 33-35℃ for 3 to 5 days in 24 patients, who suffered from severe brain injury and whose GCS scores were 3 8 as the mild hypothermia group. And 21 patients, who suffered from severe brain injury and whose GCS scores were 3-8 were taken as the control normothermia group. Fasting mane primo venous blood samples of all the patients at acute stage after injury were obtained and reserved at -20℃ in a refrigerator. The levels of serum insulin, cortisol and growth hormone (hGH) were measured with radioimmunoassay. Results The blood sugar and the cortisol were (10.25±4.18) mmol/L and (424.67± 125.85 ) ng/L respectively in the control normothermia group, but were (8.40±3.75) mmol/L and (290.71±110.50) ng/L respectively in the mild hypothermia group ( P <0.01). However, the serum insulin and growth hormone levels had no significant difference between the two groups. Conclusions Mild hypothermia therapy can reduce the level of blood sugar and ameliorate the disturbance of related hormones during glycometabolism.

关 键 词：重型颅脑损伤 血糖 糖代谢 激素 亚低温治疗 

分 类 号：R651.1[医药卫生—外科学]